Fwd: Highmark Cuts Update - PLEASE CONTACT YOUR STATE LEGISLATORS

[DonnaBav...@aol.com]

Important information and call to action for ALL physicians in PA...

DBR

 

From: st...@pamedsoc.org
To: DonnaBav...@aol.com
Sent: 3/31/2016 10:36:59 A.M. Eastern Daylight Time
Subj: Highmark Cuts Update

Dear PAMED Member: Last week I sent you a letter updating you on PAMED's efforts to convince Highmark that its fee reduction of 4.5%, scheduled to go into effect on April 1, 2016, is not in the best interests of Pennsylvania patients or efforts to lower cost and increase quality. Since sending you that letter, I have had the opportunity to speak with several members of the Highmark senior team about the cut and PAMED's request to delay and ultimately reverse it. Unfortunately, it appears that Highmark is unwilling to reverse or delay its decision. Please contact your state senator and representative and inform them about the impact these cuts will have on your patients, your practice, and your ability to provide care for patients that have purchased ACA plans. In recent press stories, Highmark indicated it currently has approximately 270,000 members covered by Affordable Care Act (ACA) plans spread throughout Pennsylvania. The insurer's fee reduction will have differing financial impacts on practices depending on the number of Highmark subscribers you see in your practice. Regardless of the impact on your practice, however, I know you will agree that this action by Highmark establishes an untenable precedent of offsetting losses with physician fee reductions.  PAMED will not stand idly by while physician fees are unilaterally reduced because it is expedient. Highmark's recently published statements indicate that physician contracts are more flexible and there is a "precedent" for such adjustments, while cutting hospital reimbursements would require hospital-by-hospital negotiations. PAMED is advocating aggressively against practices such as this and for fair contracts between physicians and insurers. If Highmark decides to restore the cuts and forge meaningful collaboration with physicians, rather than using us as financial pawns, PAMED remains open to dialogue. Assuming it does not, you have my assurance that PAMED's leadership will continue to pursue every lawful, aggressive, and comprehensive advocacy effort at our disposal, including working with the General Assembly, employer purchasers, patients, and others adversely impacted by Highmark's decision. With these efforts, we will demonstrate that the best prescription for high-quality, value-based care is a collaborative approach with the patient and their physician leading the team. In the process, we have already begun exploring new ways to sustain private practices and keep physicians in the lead of health care decision-making. My goal is to help all stakeholders impacted by these cuts, and potential future cuts, understand how Highmark's decision leaves little option for collaboration with physicians who work hard to care for patients while managing increased health care costs. Here's how you can help. Please contact your state senator and representative and inform them about the impact these cuts will have on your patients, your practice, and your ability to provide care for patients that have purchased ACA plans. Ask them to consider holding public hearings on Highmark's action and urge them to shed light on this cut to physicians despite Highmark's ample reserve and market share across our state. Urge your elected officials to stand with physicians and patients and reverse this decision immediately. Thank you to all of you who have provided comments to PAMED on the impact of this cut. PAMED staff is in the process of reaching out to you to discuss specifics of your story and how you can help to educate policymakers on the impact of this cut on your practice. If you have not contacted PAMED already, I ask that you email me at st...@pamedsoc.org and share the impact of this cut on your ability to provide service to patients insured with Highmark's ACA products. I will continue to keep you apprised of our progress through the PAMED Daily Dose and other communication vehicles. Most sincerely,   Scott Shapiro, MD, FACC, FCPP PAMED President Follow me on Twitter - @SShapiroMD    As a benefit of your membership to the Pennsylvania Medical Society (PAMED), currently you receive promotional email updates about PAMED resources, products and services. If you prefer not to receive emails promoting these benefits of membership from us in the future, follow the unsubscribe link. To ensure that you continue to receive email from the Pennsylvania Medical Society, please add st...@pamedsoc.mmsend.com to your address book. For assistance, please contact us at st...@pamedsoc.org .

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